Actual ratings depend on a complete underwriting review and vary by insurer. Underwriting guidelines and available life insurance ratings may differ by state due to insurance regulations.
Life Insurance Health Ratings & Classifications
Life insurance health ratings determine your premium costs. Insurers categorize your overall risk level based on health, lifestyle and family history.
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Updated: February 16, 2026
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Key Takeaways
Insurers assign life insurance ratings from Preferred Plus (lowest rates) to Table Ratings (highest rates), with each category reflecting specific health and lifestyle criteria that directly affect what you’ll pay.
Preferred Plus classification offers the lowest premiums but requires excellent health, a Body Mass Index (BMI) between 18-29 and minimal family health history concerns.
Table ratings add around 25% per level to Standard premiums, with Table J costing 250% more than Standard rates for the same coverage.
You can improve your rating after policy approval through reconsideration, which usually requires 1-2 years of documented health improvements before requesting a review.
What Are Life Insurance Ratings?
Insurance companies categorize applicants into life insurance ratings that determine premium costs. Your life insurance rating depends on how underwriters assess your mortality risk based on health records, current medical conditions, family history and daily habits.
Insurers analyze millions of policyholder records to predict life expectancy. A person with controlled high blood pressure might qualify for Standard Plus. You'll likely qualify for Preferred Plus if you have no health issues and are at a normal weight.
Each company uses similar life insurance rating structures but weighs risk factors differently. One insurer might offer Standard Plus for managed diabetes, while another assigns Table B.
Preferred Plus (Super Preferred)
Preferred Plus gets you the lowest available premiums. Your BMI needs to be between 18 and 29, normal blood pressure and cholesterol, no diabetes or heart conditions, and zero medications for chronic health issues.
Family history must show no immediate relatives diagnosed with heart disease or cancer before age 60. Tobacco use and most prescription medications beyond vitamins or seasonal allergy pills disqualify you from a Preferred Plus rating.
Preferred
A Preferred rating accepts a BMI of 30-31 and controlled health conditions. Well-managed high blood pressure or cholesterol won't disqualify you. This applies even if you have minor health issues as long as treatment keeps them under control.
Standard Plus
Standard Plus falls between Preferred and Standard, with a BMI range of 32-33. Insurers accept a history of minor surgeries, slightly high cholesterol despite medication, or other moderate health factors.
Premiums cost more than Preferred Plus. Standard Plus classification works for applicants who miss Preferred criteria but don't need Standard's broader acceptance.
Standard
Most applicants receive a Standard life insurance rating, which accepts a BMI of 34-38 and controlled health conditions like medicated high blood pressure, managed diabetes, or above-ideal weight without other major issues.
Costs exceed Preferred Plus, but you avoid the big jumps from table ratings. Standard's broad acceptance makes it accessible to many Americans with common health concerns.
Table Ratings (Substandard)
Table ratings apply when health conditions, a high BMI or a risky lifestyle increase mortality risk above the standard. Ratings go from Table A (or Table 1) through Table J (or Table 10). Each level typically adds 25% to your Standard premium: Table A adds 25%, Table B adds 50%, continuing through Table J at 250% above Standard rates.
Expect table ratings with a BMI of 41-48, serious conditions like heart disease or cancer, multiple chronic illnesses needing extensive medication, or recent major health events. Letter designations (A-J) and numbers (1-10) refer to the same system. The 25% increments stay consistent across insurers.
Tobacco/Smoker Ratings
Companies separate Preferred Smoker and Standard Smoker based on health factors other than tobacco use. Smoker life insurance premiums are higher than non-smoker rates. The gap reflects tobacco's mortality risk.
Classification includes cigarettes, cigars, chewing tobacco, nicotine patches, vaping and any nicotine-containing products. Weekly cigar smokers get the same rating as pack-a-day cigarette smokers at most companies, though some allow exceptions for one cigar monthly or less.
Factors That Affect Life Insurance Ratings
Insurance companies look at health records, weight, family background and daily habits to assign your rating.
Medical History and Current Health
Underwriters review pre-existing conditions, chronic illnesses, mental health treatment and current prescriptions. Well-controlled diabetes allows Standard Plus. Poor management results in table ratings.
Cancer survivors typically wait 2-5 years after treatment before qualifying for standard ratings. Depression or anxiety treated successfully with medication for several years allows standard ratings.
Recent hospitalizations or unstable treatment postpone applications. Prescriptions show condition severity.
Height and Weight (BMI)
Companies publish build tables showing acceptable weight ranges for each rating class. A 5'10" person at 180 pounds has a Body Mass Index (BMI) of 25.8, qualifying for preferred ratings. Same height at 240 pounds produces a BMI of 34.4, resulting in Standard.
Recent significant weight loss raises questions about underlying conditions. Stable weight over several years shows consistent management. Build charts vary by company.
Family Medical History
Family health events affect your rating even when you're healthy. Heart disease in a parent before age 60 prevents Preferred Plus. After age 70, it doesn't affect the rating.
Having multiple family members with cardiovascular disease makes a stronger impact. A parent diagnosed with cancer at 45 affects the rating more than a diagnosis at 75. Pancreatic or lung cancer in family members affects ratings more than skin cancer.
Lifestyle Factors
Daily habits and activities affect mortality risk apart from current health.
Can You Change Your Life Insurance Rating After Approval?
A rating reconsideration lets you request premium reductions after showing sustained health improvements. Most insurers allow reconsideration requests 1-2 years after issue, though timelines vary by company and original rating reason.
You'll need documentation that'll prove improvements. Weight loss needs medical records showing stable maintenance for 12-24 months. Tobacco cessation requires proof of nicotine-free status through test results and physician confirmation. Improvements in medical conditions require documented evidence of stable management through lab results, medication records, and physician statements.
PREPARE FOR A MEDICAL EXAM
You'll need a new medical exam. The exam must show current health metrics meeting better rating criteria. Blood pressure, cholesterol, blood sugar, weight and other measurements must fall within target ranges for your desired rating. Some insurers waive exams for simple changes like reaching tobacco-free anniversaries, but most rating improvements need a full underwriting review.
What to Do If You Get a Poor Life Insurance Rating
A poor rating won't permanently lock you into high premiums. Several strategies can reduce costs or improve classification.
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Check the rating reason: Request your life insurance underwriting decision letter explaining which factors caused the classification. Errors in medical records or misunderstood health conditions sometimes lead to incorrect ratings. If you find inaccuracies, provide correcting documentation.
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Compare insurers: Each company has underwriting guidelines with different risk tolerance for specific conditions. One insurer assigns Table C for controlled diabetes, while another offers Standard Plus for identical health. Get quotes from at least three companies to find the best rating.
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Find other policy types if traditional life results in unaffordable costs: Guaranteed issue life insurance policies require no medical exam and accept all applicants, but offer limited coverage and higher premiums. Simplified issue policies ask health questions but skip medical exams. Group life insurance through employers provides coverage without individual health ratings, though amounts may be limited.
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Improve health and reapply later: If a poor rating is due to recent health events, temporary conditions, or correctable issues, postpone coverage until you can show better health. Losing weight, controlling blood pressure, completing diabetes management programs or staying tobacco-free for required periods can improve future ratings enough to justify waiting.
Health Ratings for Life Insurance: Bottom Line
Life insurance ratings determine premium costs through standardized classifications evaluating medical history, current health, family background and lifestyle. Preferred Plus offers the lowest rates for applicants with excellent health. Table ratings multiply premiums for higher-risk profiles.
Compare multiple insurers since underwriting standards vary across companies. Consider rating reconsideration after showing sustained health improvements.
Life Insurance Health Ratings: FAQ
What is the best life insurance rating class?
Preferred Plus (also called Super Preferred) offers the lowest premiums. It requires excellent health, an ideal BMI, no major medical history and a clean family health history.
How long after quitting smoking can I get non-smoker rates?
Non-smoker status requires a minimum of 12 months tobacco-free. Some companies want 24 months. Preferred Plus non-smoker status may require five years without tobacco or nicotine.
What happens if I'm denied life insurance?
A life insurance coverage denial doesn't mean you're uninsurable everywhere. Try applying with different insurers, as each has its own underwriting guidelines. Consider guaranteed issue or simplified issue policies, which don't require medical exams but have higher premiums and lower coverage limits.
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About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.
Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!
He writes about economics and insurance, breaking down complex topics so people know what they're buying.